tennis is intense leg 44f.pdftennis leg - rupture of the plantaris tendon typically occurs in...
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Tennis is Intense
Fellow name
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Axial T1
44 yo female patient with acute leg pain after a recent injury
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Axial FS fluid sensitive
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Coronal FS fluid sensitive
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Sagittal FS fluid sensitive
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Tennis Leg!
• Complete tear of the proximal tendinous portion of the plantaris with retraction of the hypertrophied tendon
• Low grade strain within the medial head of the gastrocnemius muscle
• Perimuscular edema involving the soleus, popliteus, and gastrocnemius muscles (mostly located between the medial head of gastroc and the soleus)
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Relevant Plantaris Anatomy
- Absent in 7% to 10% of the population
- Arises just superior and medial to the lateral head of the gastrocnemius muscle
- Part of the posterosuperficial compartment of the calf
- Forms the triceps surae muscle, along with the gastrocnemius and soleus muscles
Image on lef from Radsource
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Relevant Anatomy
- Arises from the lateral supracondylar line of the distal femur
- Muscle belly lies deep to the lateral head of the gastrocnemius muscle
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Relevant Anatomy
The long thin tendon courses obliquely and medially, lying between the soleus and medial head of the gastrocnemius muscles
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Relevant Anatomy
- Distally, the tendon lies near the medial border of the Achilles tendon
- Inserts on the calcaneus just anteromedial to the Achilles tendon or onto the Achilles tendon itself
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Musculotendinous junction of the plantaris seen on longitudinal US image
Thin plantaris tendon seen on LG and TV US images
US Anatomy
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Tennis Leg
- Rupture of the plantaris tendon typically occurs in middle-aged patients - Mechanism of injury is forced dorsiflexion of the ankle with the knee in extension (e.g. pushing a car) - The injury may be accompanied by an audible “pop” in the calf. - Frequently there is a palpable mass, caused by a hematoma - Term is also used more generally and may refer to a strain of the medial head of the gastrocnemius muscle or the soleus muscle - Injuries to the medial head of the gastrocnemius muscle are more common than plantaris tendon rupture
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Tennis Leg
Medial head of the gastrocnemius partial tear
Hemorrhage and edema with a soleus muscle tear
Images from Radsource
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Companion Cases
Images from Radsource
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Complete rupture of plantaris tendon on US
Companion Cases
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References
1. Delgado, Gonzalo J., et al. "Tennis Leg: Clinical US Study of 141 Patients and Anatomic Investigation of Four Cadavers with MR Imaging and US 1."Radiology 224.1 (2002): 112-119.
2. Radsource – Tennis Leg